Group urges flu shots for all healthcare workers

NEW YORK (Reuters Health) - Flu shots should be mandatory for all healthcare workers, a U.S. medical association said Wednesday, noting in a statement that such a mandate was "necessary and long overdue."

The statement, published by the American Academy of Pediatrics, said healthcare-related flu outbreaks were becoming more common.

Still, less than four in 10 healthcare workers were vaccinated against swine flu and seasonal flu in 2009, according to data from the U.S. Centers for Disease Control and Prevention in Atlanta.

"Unfortunately, we haven't been able to get the immunizations up to the level that we need to make an impact," said Dr. Michael T. Brady, who chairs the academy's committee on infectious diseases. "We have healthcare workers that have the same unfortunate misconceptions as people in the general population."

Brady, also of Nationwide Children's Hospital in Columbus, Ohio, said some people believe vaccines cause flu, while others are concerned about safety issues.

But in the vast majority of cases, those worries are unfounded, he said.

"Clearly, this is a vaccine that has been around a long time, and the benefits far outweigh the risks," he told Reuters Health.

The new statement, which will appear in the journal Pediatrics, said the flu virus kills more than 36,000 Americans every year. It also racks up a bill of about $87 billion a year, most of it in lost work time.

It is unclear how big a role healthcare-acquired infections play, but studies show they do occur.

In one intensive care unit for newborns, for instance, 19 of 54 babies were infected by the staff, most of whom had not received flu shots. Six babies got sick and one died.

While many hospitals have launched educational campaigns to make employees get flu shots, the authors of the new statement say harsher measures are called for to protect patients.

Nationwide Children's Hospital began requiring flu shots for all employees last year. Brady, who does not have ties to vaccine makers, said the initiative had cut sick days and generated only minimal complaints among staffers.

But some experts remain critical.

"The current bandwagon effect of organizations recommending mandatory vaccine is concerning," said Dr. Melanie Swift, the head of occupational health for Vanderbilt University Medical Center in Tennessee.

"All of the studies that looked at healthcare worker vaccination and influence on nursing home residents show that in order to be effective, you need to vaccinate the patients," she said. "Healthcare worker vaccination rates play little if any role in patients outcomes."

She said hospitals mandating flu shots should be monitoring patients to see if the mandates really worked.

"It is a significant infringement on workers autonomy to be forced to take a medication to the benefit of another person -- especially when that benefit is theoretical," she told Reuters Health.

The American Academy of Pediatrics said in its statement that a mandate was ethically justified, although exemptions might be granted for medical or religious reasons.

"Employees of health care institutions have an ethical and professional obligation to act in the best interest of the health of their patients," the statement said.